Summer seasonal depression is real and deadly

By Lisa Marie Basile | Fact-checked by Davi Sherman
Published July 2, 2024

Key Takeaways

  • Seasonal affective disorder (SAD), a type of depression that sets in when the seasons shift, often impacts patients during the cold winter months. That said, some patients experience SAD in the summer—known as summer seasonal depression or reverse SAD. 

  • Summer SAD symptoms include insomnia, decreased appetite, weight loss, or violent and/or aggressive behavior. It occurs for a myriad of reasons, from genetics to lifestyle shifts. 

  • The risk of suicide increases in the warmer months, experts say, making summer SAD potentially more fatal.

When you think of seasonal affective disorder (SAD)—a type of cyclical depression that affects people when the seasons shift—you likely envision the cold, dark dregs of winter. However, summer seasonal depression, also known as reverse SAD, is also a reality.[] 

Unlike its wintry counterpart, summer SAD is not as common or well-studied. Specifically, the prevalence rate of summer depression is lower than winter depression: 0.1% and 3%, respectively.[] That said, summer SAD may be more insidious, as suicide rates jump in the warmer, rather than the colder, months. In the Northern Hemisphere, more suicides occur in April, May, and June than in December, according to John Hopkins Medicine.[] More so, research out of Serbia from 2011 found that increased environmental and air temperature are also associated with “violent suicide.”[]

A closer look at summer and winter SAD symptoms

Patients who have SAD typically see a recurring seasonal pattern each year, with symptoms lasting about four to five months.[] Patients may feel sad, “empty,” or anxious and may lose interest or pleasure in hobbies, experience fatigue, have cognitive difficulties, and see changes in sleep and eating patterns. They may also report physical pain or digestive issues. Thoughts of death or suicide can also occur. 

While winter SAD causes oversleeping and overeating, namely of carb-rich foods, summer SAD can present differently. Symptoms specific to summer depression may include insomnia, decreased appetite, and weight loss, according to StatPearls.[] Patients may also display violent or aggressive behavior.[]

Why do people feel depressed in the summer?

First, genetics may play a key role in SAD. Some studies have pinpointed a potential connection between the disorder and gene variants that control dopamine, G proteins (proteins that are involved in the genesis of depressive states), and serotonin synthesis.[][] More so, certain genes can be more or less active during the summer or the winter months. SAD is also more common in those who have a family history of depression or bipolar disorder. 

Summer seasonal depression is also more nuanced than its winter counterpart, precisely because people are expected to be happier in the summertime, says Greg Hammer, MD. “Everyone else appears to be enjoying the pool or lake, playing volleyball on the beach, or taking long strolls with a loved one in the evening. So why are we not experiencing these good times? Our expectations are high, so we are easily disappointed,” he says. 

Several factors play into why someone might experience summer SAD,  Dr. Hammer says. These might include body image issues that worsen when someone heads to the beach wears less clothing to beat the heat. 

Another culprit? “The change in lack of a predictable schedule,” Dr. Hammer says. “Children are off school and need attention. College-aged kids are home, too. The house is a mess. Our work schedules are disrupted and we have a hard time being productive.”

Compounding the situation, these changes in routine inevitably lead to sleep, exercise, and diet disruptions, Dr. Hammer adds. He says that while the so-called winter blues may be caused or exacerbated by reductions in serotonin and vitamin D3—due to lack of sunlight—“excessive amounts of melatonin in some people during the winter months may cause sleepiness and disruption of sleep-wake cycles.” 

For other patients, hiding from the heat can lead to depression: “Many of us do not tolerate heat and humidity well. We end up holed up in our air-conditioned bedrooms, feeling isolated,” Dr. Hammer says. 

But why do suicide rates jump in the warmer months? Research from 2012 postulates that sun exposure could have an influence on suicidality, although this is not confirmed.[] In fact, 2015 research published in BMJ Open found that despite the uptick in suicides in spring and summer, sunlight exposure is likely not the root cause.[]

An interview with ​​psychiatrist Adam Kaplin, MD, PhD published by John Hopkins Medicine suggests a theory: “[I]nflammation from various sources, including allergic reactions, can cause or worsen depression. Our immune system spends the winter trying to ward off viral infections, but not trying to ward off allergies, which affect more than 50 million Americans each year. Seasonal allergies in the spring put a large number of Americans at a higher risk for depression.”[]

Remind your patients

Patients can be diagnosed with SAD if they experience SAD symptoms for at least two consecutive years.[] Their depressive episodes must be more frequent during the summer or winter season than during other times of the year. 

Patients should be encouraged to do a few key things to manage their SAD, according to Rachel Goldberg, LMFT, the founder of Rachel Goldberg Therapy in Los Angeles, CA. “Some ways to combat summer SAD include trying to maintain a regular sleep schedule, staying cool, exercising regularly, maintaining a healthy diet, and not pressuring yourself to do things that you inherently know don’t bring you joy,” she says. 

For patients, regular exercise can increase mood-boosting endorphins. For patients with summer SAD, working out outdoors should be limited to early morning or later afternoon hours when the sun isn’t at its strongest. 

Solid sleep hygiene is also key, says Dr. Hammer. The goal, he says, is for patients to stick to a dedicated sleep routine. This includes going to bed at the same time each night, avoiding blue light screens before bed, nixing caffeine after noon, and keeping the bedroom dark and cool.

What this means for you

Recognizing summer seasonal depression, or reverse SAD, is crucial for patient care due to its potential severity. Early detection, prioritizing mental health, and professional intervention are essential. Encourage patients to maintain regular sleep schedules, stay cool, and strengthen their support networks to manage symptoms effectively.

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